Utilization Review Nurse Specialist

5 days ago


Center Line, Michigan, United States LanceSoft Full time
Job Title: Utilization Review Nurse

Job Summary:
LanceSoft is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing and managing patient care in post-acute settings, ensuring that patients receive the necessary care and resources to achieve optimal health outcomes.

Key Responsibilities:
• Conduct thorough reviews of patient care plans to ensure alignment with InterQual criteria
• Collaborate with healthcare teams to develop and implement effective care plans
• Coordinate with payers and healthcare providers to ensure seamless transitions of care
• Utilize clinical knowledge and experience to identify opportunities for improvement in patient care

Requirements:
• Current unrestricted Michigan Registered Nurse license
• One year of experience in a health insurance plan or managed care environment
• Certification in Case Management preferred
• Above average computer skills
• Clinical experience in ICU, ER, or medical surgical unit preferred

What We Offer:
LanceSoft offers a dynamic and supportive work environment, competitive compensation, and opportunities for professional growth and development.

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